Transference Communications As Clinical Facts

ID45H Making Meaning

Gilhooley

Transference Communications as “Clinical Facts”

From the following descriptions, consider the patient’s statements and actions as forms of transference. Explain the meaning of these statements and actions from the point of view of transference.

Rat-Man:

In the second session of his treatment by Freud, the Rat-Man describes the rat torture: I sat between two officers, one of whom, a captain with a Czech name, was to be of no small importance to me. I had a kind of dread of him, for he was obviously fond of cruelty…we got into conversation and the captain told me an especially horrible punishment used in the East…

As he told Freud the details of this torture, the Rat-Man paced around the consulting room. When he was unable to speak the words necessary to complete his descriptive sentences, Freud correctly guessed the unspoken words.

After describing the torture, Rat-Man then imagined it applied first to his girlfriend, and then to his dead father. Next he tells a story so confusing that Freud asks him to repeat it three times, leaving the Rat-Main in a “dazed and bewildered state.” In this frame of mind, at the end of the hour the patient repeatedly addresses Freud as “Captain.” How can this be explained in terms of transference?

Anna O:

In 1880 Anna was an attractive 21 year-old woman of keen intellect and sympathetic character living with her well-to-do though puritanical family. Her father fell ill with tuberculosis, and she devoted herself to his care, tending him at his bedside day and night.

Perhaps brought on by the stress of this situation, Anna began to suffer from various symptoms: coughing fits, anorexia, contractures (lasting muscular spasms), trance-like states she could not later recall. When her condition worsened, she was confined to her bed. She now suffered temporary losses of vision and hearing, paralysis of the right side of her body, paralysis of muscles in her neck, severe headaches, and loss of feeling in her arms. She displayed a progressive disintegration in her ability to speak her native German, a period during which she spoke words (without grammar or syntax) from five different languages, concluding with a period during which she spoke fluent English. She experienced visual hallucinations, seeing snakes, skulls and skeletons. She refused to eat or drink. Four months after her confinement to bed, her father died. Thereafter she had intense suicidal impulses, and her bedroom was relocated from the third to the first floor.

The family physician, Dr. Josef Breuer, had initially been consulted because of Anna’s cough. He began an intensive, time-consuming treatment of Anna, using hypnosis, then the treatment of choice for hysteria. He would see Anna briefly each morning to obtain from her the topics he’d later ask her to talk about that evening while she was under hypnosis. Over the course of a year-long treatment, after Anna spoke about each symptom while in an hypnotic state, her symptoms subsided. This was a dramatic, almost miraculous cure; Anna called it her “talking-cure.” On the last day of treatment, just hours after having left his fully recovered patient, Dr. Breuer was called back to Anna’s house. There he found Anna in an agitated state believing that she was pregnant and about to give birth to his baby. How can her belief be explained in terms of transference?

Joan Douglas:

One day in 1952 Joan Douglas ran away from Chestnut Lodge Sanatorium. She went to WashingtonDC where she rented a horse, rode up Pennsylvania Avenue to the gates of the White House and demanded an interview with the President. Shortly thereafter, back at Chestnut Lodge, Joan Douglas began psychoanalytic treatment with Dr. Harold Searles. (Her previous analyst had “quit in discouragement” after a year of work.)

Douglas had first become overtly psychotic at the age of 33, when she was married and the mother of four children. Suffering from paranoid delusions, she was admitted to a psychiatric hospital specializing in somatic treatment. She underwent two courses of insulin-coma therapy (resulting in at least 70 comas), and 42 electroshock treatments without any reduction in her symptoms. A consultant recommended a lobotomy, but the family transferred her to Chestnut Lodge for “a last-ditch attempt at psychoanalysis.” Throughout her first year of four-day-a-week treatment with Searles, Joan made several serious attempts to kill members of the sanatorium staff. Searles was often afraid to work with her.

There were times, particularly in unusually stormy sessions during the early years, when I felt so threatened and enraged that I was seriously afraid lest I lose control of my murderous feelings, and kill her.

During her first years of treatment Douglas was convinced that there were 48,000 Chestnut Lodges among which she was being constantly shifted. Similarly there were doubles of everyone, including herself. She explained that there was a chain on her heart and machinery in her stomach, and that during sessions both her head and Searles’ head were being replaced by other heads. Often she reported that both she and Searles were being replaced “bodily and in toto” by a succession of other persons during the session. She felt unfairly accused about her destructive acts which she believed were perpetrated by her malicious double. “Well, there are nine hundred, ninety-seven tertiary skillion women associated with Chestnut Lodge, so why should I be blamed for everything everybody did?” she asserted. Is there any way to explain Joan’s statements in terms of transference?